Provider Demographics
NPI:1144285537
Name:HAMILTON, ISELYN YEVETTE (ARNP)
Entity type:Individual
Prefix:
First Name:ISELYN
Middle Name:YEVETTE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ISELYN
Other - Middle Name:Y
Other - Last Name:DALLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:964 RIBAUT RD
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5429
Mailing Address - Country:US
Mailing Address - Phone:843-524-5437
Mailing Address - Fax:843-524-4150
Practice Address - Street 1:964 RIBAUT RD
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5429
Practice Address - Country:US
Practice Address - Phone:843-524-5437
Practice Address - Fax:843-524-4150
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20172363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009865300Medicaid